Summary: New research from Binghamton University finds that kratom, an herbal supplement commonly used to manage pain and to reduce opioid withdrawal, carries significant risks. Reported adverse effects include rapid heartbeat, hallucinations, seizures, coma, and in rare cases, death.
Source: Binghamton University
Kratom safety under scrutiny: researchers warn the herbal supplement poses notable health risks
Kratom, a plant-based supplement native to Southeast Asia and increasingly used in the United States to treat pain and manage opioid withdrawal, is not without danger, according to a team led by faculty at Binghamton University, State University of New York. The study examined national poison center reports and local medical examiner data to better understand the types and severity of kratom-related toxicities.
William Eggleston, clinical assistant professor of pharmacy practice at Binghamton University, noticed a growing number of patients presenting with kratom-related toxicity or withdrawal. The plant contains alkaloids that interact with opioid receptors in the body, which explains why people use it for pain relief and to cope with opioid dependence. Concerned by the rising clinical encounters, Eggleston and colleagues carried out a retrospective review of exposures reported to the National Poison Data System and reviewed county medical examiner records to identify fatalities associated with kratom.
The investigators found 2,312 kratom exposure reports in the National Poison Data System, of which 935 involved kratom alone without co-ingested substances. Reported symptoms ranged from agitation, rapid heart rate (tachycardia), drowsiness and vomiting, to more severe events including seizures, hallucinations, respiratory depression, coma, and cardiac or respiratory arrest. Specifically, agitation occurred in about 18.6% of cases, tachycardia in 16.9%, drowsiness in 13.6%, vomiting in 11.2%, and confusion in 8.1%. More serious outcomes included seizure or withdrawal in 6.1% each, hallucinations in 4.8%, respiratory depression in 2.8%, coma in 2.3%, and cardiac or respiratory arrest in 0.6% of reported exposures. In the county medical examiner review, kratom was listed as a cause or contributing factor in four deaths.
“Although kratom is not as potent as some prescription opioids, it still engages opioid receptors and can produce opioid-like effects,” said Eggleston. “At higher doses, kratom can suppress breathing and cause sedation, producing toxic effects similar to other opioids. There are also reports of seizures and liver injury. While kratom may have potential roles in pain management or opioid use disorder treatment, our data indicate that more rigorous research is needed on both safety and effectiveness. Given current evidence, kratom should not be freely available as an unsupervised herbal supplement.”
These findings emphasize kratom’s public health implications. Easy over-the-counter access may lead some users to underestimate risks or to combine kratom with other substances, increasing the chance of severe toxicity. The research team is now collaborating with colleagues at SUNY Upstate Medical University to further evaluate how widespread kratom use is among patients and whether toxicity risk varies with dose or formulation.
Source:
Binghamton University
Media Contacts:
John Brhel – Binghamton University
Image Source:
The image is credited to Thehealingeast. Licensed CC BY SA 4.0.
Original Research: Closed access
“Kratom Use and Toxicities in the United States.” William Eggleston, Robert Stoppacher, Kyle Suen, Jeanna M. Marraffa, Lewis S. Nelson. Pharmacotherapy. DOI: 10.1002/phar.2280
Abstract
Kratom Use and Toxicities in the United States
Background
Kratom is an herbal supplement that contains alkaloids with opioid-like activity. This study reviewed kratom-related exposures in the United States to assess the range of toxicities and inform considerations about the product’s safety as a dietary supplement.
Methods
Investigators performed a retrospective review of kratom exposures reported to the National Poison Data System and examined county medical examiner records to identify fatalities linked to kratom.
Results
Out of 2,312 kratom exposure reports, 935 involved kratom as the sole substance. Common effects included agitation, tachycardia, drowsiness, vomiting, and confusion. Serious events—such as seizures, withdrawal symptoms, hallucinations, respiratory depression, coma, and cardiac or respiratory arrest—were also documented. Kratom was listed as a cause or contributing factor in four deaths identified by the county medical examiner’s office.
Conclusions
Kratom use is rising and is associated with substantial toxicities. The data suggest that kratom cannot be assumed to be safe for over-the-counter use and that its availability as an unregulated herbal supplement represents a public health concern. Further research is required to clarify the safety profile, potential therapeutic roles, and dose-related risks of kratom.